Projects

Building the Kankudibi Health Clinic in Bakang Village, The Jokadu District, The Gambia

Geoff and Julie were invited to visit the village of Bakang in May 2005. They were asked for financial help to build a Health Clinic.The nearest medical help is a 4 hour journey by donkey cart. This means there are many fatalities, due to the time lapse before appropriate treatment can be administered. Malaria is a big killer in this area but there are many others: T.B. pneumonia, typhoid, diphtheria, polio, diabetes. There are the usual hazards of broken limbs, infectious sores and snake bites. So the need for medical help was obvious.Asked about the labour for building a health clinic, the villagers said that they would provide all the unskilled labour, as they would be the main beneficiaries of such a facility. Skilled workers would have to be paid for the actual building, roofing, plumbing, electrical work, carpentry and plastering. The villagers would be there to fetch and carry for these skilled men.Asked about the staffing for such a facility, assurance was given that young people, who had left the village to gain qualifications, would be pleased to come back to live and work in their home village.Having had lengthy discussions with their Gambian friends, Geoff and Julie said they would do all they could to help.Geoff and Julie opened a bank account in the U.K. and also in The Gambia, so the funds could be transferred as needed. Plans for the clinic were drawn up and approved by the necessary authorities.

This Health Clinic provides the following facilities:

Reception area.

Consulting Room.

Accident and Emergency Ward.

Treatment Room.

Male Ward.

Pharmacy.

Maternity Ward.

2 x Store Rooms.

Women's and Children's Ward.

4 x Toilets.

Isolation Ward.

3 x Showers.

Seating for outpatients will be provided along the whole veranda area of the clinic.

Please remember, there is no electricity, no mechanisation and all water is drawn by hand, from a 20 metre deep well.

A 7 stage building plan was drawn up, to aid monitoring and control of the project.

The stages are as follows:

1. Making by hand, 3,600 concrete blocks. Completed in July/August 2005. £1,850 sent out to cover cost of materials (including wheelbarrows and shovels), transportation, making of moulds etc.

2. In January 2006 the digging out of the footings was started followed by the laying of the foundations of the clinic. Drainage pipes were put in place and also steel bars to strengthen walls. A further £2,000 was required to meet the cost of materials and this stage was completed in December 2006.

3. Commenced January 2007. A mason and 2 men were employed to build the walls, exterior and interior, to roof level. More blocks had to be made and the skilled men paid. £7,750 in total was sent to complete this stage.

4. Erecting the roof beams, trusses and attaching galvanized sheeting.In September 2007 the materials were bought and shipped across the River Gambia and transported to the site. Despite the heaviest rains for 30 years, work progressed and the roof was completed at the end of December. A price of £6,000 was agreed to erect the roof structure. £4,000 was sent out to buy the materials and the remaining £2,000 was sent on completion.

Payments are only made after consultation at each stage. All money spent is closely monitored and accounts and receipts are sent to the charity's treasurer in the U.K.In this way, all money raised is guaranteed to be used for the purpose for which it was donated.

5. Plastering walls and making and fitting windows and doors.January 2008 the gable ends were plastered first, followed by the outer walls.A carpenter was employed to fit the wooden rafters to take the hardboard ceiling, the latter will not be fitted until the wiring and plumbing has been completed. A further £6,000 was sent to cover the costs of professional labor and materials.

6. Installing plumbing and electrical wiring. Geoff and Julie took electric cable and components, (generously donated by a member of a Nottingham Rotary Club), to the clinic site on their recent visit. The "first fixing" was completed by a qualified electrician before they returned to the U.K. March 2008.

Since then the electricity wiring has been completed and the sockets sited. Now, in April 2009, the ceiling pendant sets, finger switches, pull switches and the main fuse box and control panel have all been installed.

Alasan Installs the Fuse Box

All that is left to do in the clinic regarding the electricity is to link up the solar power to the internal wiring. - this will be done in early June. The electrical requirements for the staff accommodation and the utility building have been agreed and the materials are about to leave UK.

We are pleased to report that recently the Solar Power had been linked up to the internal wiring of the clinic (September 2009). This solar power will also provide all the lighting requirements for the staff accommodation and that of the utility building.

9 Solar Panels to Provide the Power 18 Batteries to Store the Power Inverter & 2 Charge Controllers

And Then There Was Light!

The total cost of providing the solar power + installation £10,271

The vaccine fridge has also been wired into its own DC Solar Power Supply. It was decided to keep this unit separate from the other electrical needs in the clinic. Any failure there would not effect the safety of the vaccine in the fridge.

Vaccine Fridge in Pharmacy

The cost of the fridge, Solar Power Supply + installation £2,726

For the other equipment and lighting in the clinic, staff accommodation and utility building the solar power will pass through the inverter and so be changed from DC to AC supply.

On the plumbing side all the toilets and showers are in place as are the wash basins in the wards, the consulting room and the treatment room.

One of 5 toilets in the clinic.

Wash basin in women's ward.

Wash basin, shower & toilet in the maternity ward.

In April 2009 it was decided that all showers and wash basins should have both hot and cold water on tap.This has now been implemented with the introduction of the Solar Powered Water Heater.

Solar Powered Water Heater

The total cost of the Solar Powered Water Heater + installation £1,649

This now completes stage 6.

7. Tiling of all floors, veranda and walls of the toilets and shower cubicles.

We are delighted to say that this job has been completed in a most impressive way and has made a tremendous difference to the overall appearance of the clinic, as can be seen from the photos below (February 2009).

Male ward tiled.

Floor tiling looks good.

Tiled ramp at the front of the clinic.

Tiled steps at the back of the clinic.

The primer coat of paint has been applied to all the internal walls and ceilings and the exterior walls. Further coats of paint will be applied nearer the date of the clinic "opening".

On completion of the construction, the furnishings and the fittings will be financed by the JDDF. Local craftmen will be employed to make as much furnature as possible, giving local employment, the people a sence of ownership, and keep freight costs to a minimum.

Getting Ready for the Opening

The Big Day!!

Yes! it has happened, the KANKUDIBI HEALTH CLINIC was officially opened by Dr Gaye, the Minister of Health and Social Welfare, on Saturday 7th November 2009. This is 4 ½ yrs since the first visit to the village and the request for a Health Clinic was made.

Minister of Health Cuts the Tape

This was a momentous day for the villagers and they certainly celebrated in true Gambian tradition. There was plenty of drumming, clapping, dancing and singing and of course the usual problem with G.M.T. – Gambia Maybe Time. The proceedings were programmed to start at 11:00am, but it was 1:00pm before the final government official appeared! We then had all the speeches, plus a few extra, which were not on the programme, before it was time for Dr Gaye to cut the ribbon on the entrance door of the clinic and declare the clinic “Open”. It was then time to take the distinguished guests on a conducted tour of the clinic. We showed them the ROWSLEY WARD [Maternity] the BAKEWELL WARD [Women & Children] and the MATLOCK WARD [Men’s] and explained that these names were those of areas in which groups of people, who have given us much support, lived. There were many very favourable comments made about the overall layout of the clinic, the high standard of workmanship, the facilities it offered and the thought that had been given at the outset of the whole project. At the end of the tour the minister showed his approval by signing a very special quilted wall hanging, a signature quilt designed and created by Vivien Finch, which shows the front of the clinic as the centrepiece. Around the central picture are many quilted squares, which after making a donation to the project, people have signed with their good wishes. Before his departure the Minister again expressed his appreciation and that of the Government for what had been achieved and said that it was the best Health Clinic in the Gambia and a building of which we should be very proud. With these words ringing in our ears it was time to for us to leave and make our long dusty journey back to the port of Bara and wait for the next ferry to cross the river to Banjul and then back to our accommodation. It had been a long hot day, but one that all of us present will remember. We had left behind several hundred very happy Gambians who celebrated this momentous occasion long into the night.

The Team Celebrate

Mission Accomplished

The Minister holds the Wall Hanging

The following day we heard that there were several pregnant women, in the Jokadu District, who were all wanting to be the first to give birth in the clinic. We also heard that the first patient was a suspect malaria case, who was kept in overnight for treatment and then released.

Everybody who visited the clinic site was most impressed with all the work that Lamin, the gardener, had done. He had transplanted grass at both the front and back of the clinic and had flowers growing on what had been just barren sandy land on our previous visits.
A list of garden seeds that Lamin had requested will be bought locally. The gardening tools he needs are to be sent from the UK and should arrive just before the rainy season starts. Needless to say he was very frustrated at problems the goats, sheep, donkeys and cattle were causing, for during the nights they were either eating off or pulling up the plants that he had so carefully planted during the day. You will notice from the photos that he has constructed his own fencing to keep them away. Hence, we felt it was very necessary to work out where the perimeter wall and fencing was to go and get the job started straight away.

Garden at the front of the clinic

Lamin in the garden at the back of the clinic

Nov 2010

We are very pleased to report that the perimeter fencing around the whole Health Clinic complex has been completed. The groundsman, Lamin Yaiya Jarjou, now plans to plant bougainvillea all along the base of this wall, and allow it to grow up to the fencing. When this gets established it will give a mass of colours around the complete complex.

Perimeter fence at the front of the clinic

Perimeter fencing at the back

With the wall now completed Lamin can develop his landscaping project with peace of mind. The animals, goats, sheep, donkeys and cattle can no longer get in and destroy his hard work. The reports we are now receiving, from people returning from The Gambia, are that he has done a very good job during the rainy season. He has started by growing fruit and vegetables to feed the staff and patients. When the gardens are established any surplus fruit and vegetables will be sold and the money used towards purchasing required medicines.

Stick beans growing

Maize growing well

Growing vegetables & flowers

June 2011

On our most recent visit to the Kankudibi Health Clinic we were delighted to see the further development of the landscape gardening that the groundsman, Lamin Ayaiya Jarju, has achieved. It is not an exaggeration to say that he has transformed the whole area around the Clinic, Staff Accommodation and Utility Building. When you think that 18 months ago this whole area was just sand and dirt - as shown in the photo, taken in front of the clinic "Getting ready for opening" It is astonishing how Lamin has managed to get the grass, trees, and plants to grow. The only answer is enthusiasm, hard work, water from the standpipe and green fingers!

The front of the clinic

Banana trees growing

One side of the clinic

Lamin proudly shows off his work

He has also helped and advised the staff on how to grow their own fruit and vegetables on plots of land, which have been allocated to each unit of accommodation. We are now waiting to see the results of the bourgainvillea, which he will plant on the inside of the perimeter wall - it should be a mass of colour.

Audience with the Vice President 2011

Without doubt the highlight of our most recent visit was another audience with Her Excellency Mrs Isatou Njie-Saidy, the Vice President of The Republic of The Gambia and Secretary of State for Women's Affairs.
This was a very positive meeting and lasted 90 minutes. It is most unusual for an audience, with the VP, to last this long, but it just showed how interested and informed the VP is on what the villagers of Bakang have achieved. She thanked us for all that we had done to help the villagers and wished us to convey her most grateful thanks to the people in the UK who had been so generous with their support. She was most generous with her praise to Famara Jarjou, who has been our project manager right from the start. She was well aware that Famara had devoted most of the last 5 years in all aspects of getting the Heath Clinic built. He had encouraged the villagers to keep working and at the same time negotiated prices and obtained materials as and when required. For a Gambian man, in his late 60's, this is not easy.
The MP for the Jokadu District, Hon Kebba Gaye, who had arranged the meeting on our behalf, raised several points about the future needs of the clinic, now that it is in operation. The VP answered each point and either gave a ruling as to what had to be done or advice on how she saw the future development of the clinic. She had instructed three senior members of the Ministry of Health and Social Welfare to attend this meeting and so was able to give them instructions and advice as to what had or would be done. Certainly this lady runs the country and is held in very high esteem by all Gambians.

Needless to say all the Gambians present, including the VP, wanted to know what our next project was going to be! We managed to avoid answering that question by saying that we still had 3 ½ yrs in which we were honour bound, by the Memorandum of Understanding we had signed, to help with the running of the clinic until we handed it over to the government in November 2014.

Our audience with the VP was filmed and recorded by the National Television Company and was shown on the 8pm and 10pm national news on both Friday and Saturday nights. Our advice to anyone who wants to help in an African country is to start at the top – it has a tremendous influence when dealing with government personnel and getting decisions made.

March 2012

The highlight of this most recent visit to the clinic was to persuade the Chief Nursing Officer (CNO), Mrs Margaret Gomez to come with us. This was her first visit and it proved to be a big surprise for her.

We were met with a great welcome from the villagers and the staff. They were obviously delighted to see such an important person in their village and as usual there was plenty of singing and dancing. There were the usual speeches of welcome, but it was also made very clear that there was a big need for an ambulance. The clinic is getting busier by the day as word has spread that no matter what day or time you arrive at the clinic you will be seen, by a qualified nurse, and receive the necessary treatment. Aunty Margaret, as she is known, certainly listened to this request and said that she would put forward a proposal, when she returned to Banjul, that the government should definitely consider providing an ambulance. Awa, the head nurse, then took the CNO on a conducted tour of the clinic. She answered all the questions that Margaret asked and made several suggestions, which would be of help in the future. Several things that had been incorporated in the construction of the clinic surprised the CNO. She was so impressed she insisted that she had photos taken and said that these photos would be used when future construction of hospitals/clinics was being considered. Finally, after inspecting the utility building and the staff accommodation the CNO made a telling remark to the staff. She said "do not ask for a transfer because you will never find facilities or accommodation as good as this anywhere else in The Gambia" That, we consider, is praise indeed for the tremendous effort of all the Gambians who had worked on this project.

Villagers saying welcome

CNO Margaret Gomez & Mr Sootay

So pleased to see you

Lamin Yaiya Jarju, the gardener, continues to enhance the whole area around the Health Clinic. Despite less rain between June and December last year he has still managed to grow more vegetables for consumption and has started to train the bougainvillea to grow up the perimeter walls.

The probability of much colour in the years to come?

During this last visit to the clinic we discussed the need for either more solar panels to be added to the existing number or introducing a separate solar unit for the staff accommodation/utility building.
The reason for this is because the demand for electrical power has increased as the whole project has expanded ahead of the original idea! We are now in the process of deciding which way to move.

Another success for us, on this visit, was to ask the wood carver @ Kololi Beach Club to carve a new KANKUDIBI HEALTH CLINIC sign, which has been screwed to the perimeter wall near the main gate.

January 2013

We have just received some more photos taken by visitors on their first visit to the Kankudibi Health Clinic. To say they were very impressed is not an exaggeration. They were amazed to see what a magnificent job our gardener, Lamin Yiaya Jarju, had done, landscaping the whole area in which the clinic stands. You will have already seen the progress he has made since the construction work was completed in October 2009. [If you have missed this then go back through the Project page to the time when the clinic was ready for "opening"]
We are now adding 3 more photos, one of which shows the lad himself with the bougainvillea he has grown from seed.

Outside the Main Gate[Donkey, cart & driver – the transport for sick patients waiting in the shade before the return journey home]

April 2014

Increase in the use of the clinic

During our visit in April 2014 we discussed with the nurses and the midwife the large increase of both adults, and children under 5 yrs old, now being seen / treated at the clinic. In 2012 the overall number of patients was just over 2,500 and 14 babies. However, during 2013 there had been a large increase. Adults seen / treated rose to 3,869 and children numbers rose to 2,187. This gave an overall total of 6,056 - an increase of 142%. Babies born in the clinic rose to 27 – an increase of 92%. Now, in the first 3 months of 2014, 13 babies have been born. We are assured that it has nothing to do with an increase in productivity in Bakang. Apparently the Government have instructed pregnant women in the Jokadu District and the surrounding area to use the facilities at Kankudibi Health Clinic rather than travel to Kerewan, Kuntair or Essau. At last someone in higher reaches of the government has noticed the potential that is now available, close at hand.

Kankudibi Health Clinic - Ambulance

This vehicle was given to us in December 2013 by the charity that hails from Denmark named Pass it Forward. They work in collaboration with a Gambian charity called Advocacy for a Better Environment. This vehicle, despite its age of 40 years, brought a load of football garments, equipment, footballs, footwear and other items from Copenhagen. Having driven down through Europe and then North Africa loaded, we feel sure that it will stand the challenge of the village tracks / terrain in the Jokadu District. It was just a large van when we took delivery. Now, thanks to some effort and craftsmanship, it has been changed into a basic ambulance. It has a siren and a blue flashing light. Windows have been fitted and seating is down both sides of the interior. There is also room for a stretcher, or two, and wide back doors for an easy entrance with patients. A local man, Lamin Saidy, aged 30 years, has been selected to drive this vehicle. He is currently undergoing medical training @ Essau Hospital and will also train on how to handle sick and infirm patients to and from the ambulance. On completion of this, he will have a course of mechanical training from staff of "Riders for Health". The maintenance of this vehicle will be carried out by Riders for Health at their Kerewan Garage. We will give this vehicle to the Government, when we hand over the whole Kankudibi project to the Government of the Republic of The Gambia, through the Ministry of Health and Social Welfare, on Saturday 8th November 2014.

In both photos this ambulance looks impressive.

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The Big Event, on Saturday 8th November 2014

After 5 years of helping with the maintenance and administration at the Kankudibi Health Clinic, at Bakang, following its 'opening' on 7th November 2009, we have now given this prestigious building to the Government of The Republic of The Gambia. We agreed to this when we signed the Memorandum of Understanding with the Gambian Government on 2nd March 2006.

There was much singing and dancing by the villagers of Bakang / Karantaba and those from the surrounding areas. There were the usual speeches from prominent people highlighting the success that has developed in the 5 years since the clinic was 'opened'. Since that day, till 31st October 2014, 154 babies have been successfully delivered in the maternity ward. The number of adults seen / treated in 2013 was 3,869 and the number of children, under 5 years of age was 2,187 - a total of 6,056. What started as a Health Clinic for Bakang and Karantaba villages has now spread to 10 villages in the Jokadu District. Patients will also walk from neighbouring Senegal, some 2 days away, in order to receive treatment. You may well ask why go to all that effort. Well, the word has spread that since the clinic was 'opened', back in 2009, it has never closed. People now know that they will receive treatment no matter what time or on which day they arrive. A Gambian trained Nurse will be there to see them and there is also a resident Midwife available.

Plenty of People

Joan, Lamin, Famara, Geoff, Julie

Lamin Speaking

Lots More Guests

Although members of the Ministry of Health and Social Welfare, from head office in Banjul, were 'noticed' by their absence, it was a pleasure to hand the keys, of the Kankudibi Health Clinic, to Mr Soutey Drammeh, who is the Principal Nursing Officer for the Jokadu region. On reflection, it would appear he was the correct person to receive the keys. Mr Soutey Drammeh made a number of visits to the clinic, while it was being built. We met him on several occasions, when we would visit the site to check on progress and future needs.

Geoffrey Henson hands the clinic keys to Soutey Drammeh

A major talking point at the 'handover' was the fact that following a country wide visit to check on Health Clinics, in April this year, Kankudibi Health Clinic was pronounced "the cleanest and the best". As a prize, the resident midwife, Aja Bojang, was flown to Turkey for a 2 month advance course on midwifery, which she found most stimulating.

Midwife, Aja Bojang

In recognition for the outstanding contribution that Famara Jarjou made towards the whole Kankudibi Health Clinic project, our charity decided to take this opportunity to present to him an old fashion door key which was mounted on a wooden plinth. Under the key, on a brass plate is written:

KANKUDIBI CLINICThe Key to Good HealthPresented byGeoff & Julie Henson and the J.D.D.FUND08-11-2014

We are very proud to say that Famara was one of the instigators of the original idea of a Health Clinic in the village of Bakang. He and his relations donated the land on which the whole project was built. He, as a senior member of the village community, set the guidelines on how this clinic was to be built to the highest standard. He introduced a rota system so that people from each compound were able to divide their time between working on the clinic construction and making sure that the land was worked to provide the families with food. He negotiated the prices paid for the materials and rejected any material that was below the standard required. From the initial day when the site for the clinic was decided to the day the clinic was "opened" - 7th November 2009 - Famara was to be found encouraging those people working, praising their good work, helping those who were having difficulties and leading the whole team of workers by example. After the clinic was opened Famara had to move, for health reasons, from Bakang to Wellingara. However, for the next 5 years, he was often seen on the ferries crossing to Bara for yet another visit to Bakang to both help and check on the added extras that have been introduced during this time. We would also like to say that his son, Lamin, also worked tirelessly in making sure that the bills were paid on time and that the receipts were sent to England, thus ensuring that the money was spent wisely and well. Having an honest and trustworthy person handling the money for the charity, was a very important factor in the success of the whole enterprise.

Famara receiving the key from Julie Henson

Famara accepted the key on behalf of villagers of Bakang and has requested that it be on display, in the reception area, for all patients and visitors to see.

Lamin, his Mother, Famara, Aja Bojang & Geoff

Another pleasing sight was to see a representative, of Karantaba Youth team, handing over several boxes of medical products, bandages, dressings etc which they had gathered together, to Masaneh Camara, senior nurse at the clinic. They said that they wanted to be part of the overall team, which has done so much to bring the villagers together. The Kankudibi Health Clinic is now a very important focal point, for the Jokadu District, and all the villages within that district.

Masaneh Camara receiving the boxes of medical goods

What has the future in store for this Health Clinic, built by villagers for villagers?

We know that, since the handover, government personnel have visited the clinic and have both spoken to and taken details from the staff now working there. Prior to the handover we asked the Minister of Health and Social Welfare, Hon Omar Sey, that the villagers of Bakang be included in any discussions about future plans for the clinic. We are pleased to report that we received an official written answer, on the 23rd May 2014 which read:

So now we will await future developments.

Official visit of Hon Omar Sey Minister of Health & Social Welsare to Kankudibi Health Clinic

Having been unable to keep his promise to attend the official hand over of the Kankudibi Health Clinic, to The Government of The Republic of Gambia on the 8th November 2014, The Minister of Health and Social Welfare, the Hon Omar Sey, finally made his official visit in early March 2015.

On this, his first visit as M O H, he was accompanied by the Jokadu District Chief, Mr Jim Fatima Jobe, the Chief Nursing Officer, and the Regional Health Management Team from Essau. As is common in The Gambia, there was much singing and dancing by the villagers, on the Minister’s arrival. The villagers were delighted to show off the excellent building they had built using the materials that our charity had provided. After welcoming speeches it was time for the Minister to be taken on a conducted tour of the clinic and its facilities, by the head nurse Masaneh Camara. Inside the building the Minister was shown the 5 different wards, with their own toilets and shower facilities, consulting room, treatment room, pharmacy and store room. We understand that the Minister was very impressed with what he saw and with the information he was given by the head nurse, another nurse, Mama Sima, and the midwife, Aja Bojang. The fact that the clinic had already been in use for over 5 years and yet it was so clean and tidy, both inside and outside, really did make a very good impression. It was pointed out that the 3 cleaning ladies took great pleasure in their job and worked well with the nurses. The Minister was then shown the accommodation for 4 Nurses/Staff, with each having a bedroom, lounge and outside kitchen and then the utility building with the facilities of a kitchen, laundry, net dipping room, 2 x store rooms, 2 x toilets. Finally he was shown the bore hole with the solar power driven water pump, which provides all the water requirements. Another important point was made about the use of Solar Power for all the electrical needs in the Health Clinic, the Staff Accommodation and outside lighting.

Warm up ActCleaning Ladies.

Minister of Healthand Management Team

Minister in discussionMid-Wife listens.

Minister talks to Head NurseMasaneh Camara.

Minister talking to DistrictChief - Jim Fatima Jobe

It is good to relax aftera busy afternoon

Before leaving, to return to Banjul, the Minister announced that he would arrange for the gardener/handyman Lamin Yiaya Jarju, the ambulance driver and the most recent security guard, to be placed on the government payroll. This was in recognition for the standard of work they produced. H e also said that he would arrange for more maternity equipment to be sent from Banjul hospital. Finally, while traveling back to Banjul the Minister phoned Lamin Jarjou, our main contact in The Gambia, and told him what a pleasure it had been to visit such well run, efficient, Health Clinic. He asked Lamin to make sure that the Charity Trustees also received a copy of his message.

At last, a visit from the current Minister of Health and Social Welfare, which was long overdue, but a big success.

Details of Staff Accommodation & Utility Building

In February 2008 it was decided to add the construction of staff accommodation and that of a utility building to the Kankudibi Health Clinic project. Plans were drawn up for the provision of 4 bedrooms and 4 sitting rooms for the nursing staff along with a room for use as a medical library/reference centre. Details of the plans are shown below.

Staff Accommodation Plans

Plans have also been completed for the utility building, which will provide:

Now that the rains have stopped, Dec 2008, it is all hands to the spades and shovels to complete the digging out of the "footings" for the staff accommodation and the utility building.

Utility Building

Staff Accommodation

Work on the 2 large septic tanks/soak-aways, 1 either side of the clinic, has been started by a local contractor.

Ready for the blocks

The septic tanks have now been constructed and it just remains for the clinic outflow pipes to be connected and the concrete tops to be made and put in place.

A section of a septic tank

This has allowed the local villagers to concentrate on the making of more building blocks in readiness to start the building of the staff accommodation. At the last count, when we visited the site 4,900 were drying in the sun.

Mixing the materials

Making blocks

Some of the blocks drying

We are very pleased to report that the building of the staff accommodation is progressing well, as can be seen from the photos.

Many hands make light work

Some of the 9 rooms taking shape

Up to window level

In April 2009 we purchased Alumin Corrugated roof sheeting for the staff and the utility buildings. The mahogany wood for the beams, rafters and purlins is already cut and on site.

The latest photos (September 2009) show the staff accommodation almost complete and the utility building taking shape.

Inside Plastered

Ceiling in Place

Outside awaiting plastering

Utility Building Taking Shape

The decision has been taken to add the security office to the utility building rather than have a separate unit.

On our most recent visit to The Gambia, at the end of April 2010, we were able to finalise plans for the completion of the construction work. With the Kankudibi Health Clinic now up and running, and the Staff Accommodation, the Utility Building and the Generator shed, housing the diesel generator, all completed it was time to agree costs for the final work to be done.

Utility Building

Generator Shed

Generator inside

Plans for the perimeter wall and fencing were drawn, discussed, priced and agreed. Lamin Kanteh, the mason we used for building the Staff Accommodation and the Utility Building, was offered the job and agreed to start in early May.

It has been decided to have separate outside toilets for the staff accommodation, rather than use the clinic facilities, a store shed to keep garden materials and tools, and a security hut at the main gate.

Furnishings for the staff accommodation, beds, chairs, tables, wardrobes and shelving were either bought in Serrekunda or are to be made by the Kololi carpenter, Sulayman. All the bought items have already been delivered and are in use, much to the delight of the staff.

Nov 2010

We understand that the main gate, at the front of the clinic, is now in place and that the security hut has been built next to this gate. There is a small gate in the perimeter fence at the back of the clinic for easy access to the village.

A building, to be known as "Barker's Store", has now been completed. This store is alongside the generator shed, and will hold all the equipment and materials for use in landscaping the clinic grounds.
The villagers have provided an additional water supply, by way of a standpipe placed within the grounds of the clinic. This water has come from a borehole that the government sunk in the summer it will be used to water plants in the garden so negate the need to use any of the water from the clinic borehole.

Barker's Store being built.

Stand pipe for garden water supply.

June 2011

From the photos below you can see that all the construction work has now been completed. We had discussions on our recent visit and agreed that the inside of the perimeter wall would be painted and the outside of the wall would be pebble dashed and then painted. We now hear that this has been done and the security hut has also been painted.

Staff Block

Main Gate with Security Hut

Barkers Store

September 2012

During the past 24 months we have heard of occasional problems with a shortage of electrical power, in the Health Clinic, during the early hours of the morning. At first we thought it was because the acid storage batteries were not performing as required. We had ordered and paid for Gel batteries, but these had not been supplied. Despite many requests for the Gel batteries, falling on deaf ears, we decided to write to the VP. The Gel batteries were delivered within 10 days and the electrical supply improved. However, we were made aware that the nursing staff were wired into the solar power [this was not in the original plans] and of course this was putting an additional demand on the power stored in the batteries. On our visit, in March of this year, we discussed this problem and decided that it was an opportunity to either increase the number of solar panels for the Health Clinic or install a separate supply of solar power to the staff accommodation and include the Utility building. We decide to go for the second option. We purchased the main requirements from True Energy Ltd, based in Gwynedd, N Wales. It was this company from whom we bought the special vaccine fridge, built to WHO standards, back in 2009. The items we bought were:

These items were then sent to The Gambia by sea and arrived on 13th September. It was decided that the necessary wiring, switches, etc should be bought in Banjul, along with the steel to make the frame to support the Solar PV Modules and any other needs. Alasan Jarju, a qualified electrician, will undertake the installation of this additional source of power in October. The estimated cost of the all units, equipment, wiring, + installation + delivery will be £4,000

January 2013

We are pleased to report that the separate supply of Solar Power has now been installed to serve the Staff Accommodation and the Utility Building. This has released the pressure on the original solar supply to the clinic. Initial reports say that it is working well.

Frame Made for 3 X Solar Panels

Happy, Smiling Children While Work Continues on the Roof

Solar Panels in Place, Ready to Work

Building of Staff Kitchen

Following the request from the Nursing Staff we were able to start building the kitchen in April. From the photos shown you can see it only needs the roof going on and plastering completed. Painting, to match the other buildings, will follow before the rain comes.

New Staff kitchen being built

Cooking facilities - no roof yet

Nurse Training Course

During the visit in December 2008 to The Gambia we had the pleasure of congratulating our 2 Nurses, Karafa and Awa, whom we had sponsored on a 2 year Nurse Training Course, held in The Gambia. They had just completed the course and are now fully qualified to S.E.N. status.

Karafa Marong & Awa Bojang

We took the opportunity of taking them to see the Kankudibi Health Clinic, which will be their new place of work, when it is ready to open - hopefully this will be at the end of May 2009. They are contracted to run the clinic for a minimum of 2 years as repayment for their training. Although the clinic is some way from finished they were very impressed with what they saw. They were also most helpful in making constructive comment on how we could provide facilities, which would be of benefit to both staff and the patients.

Karafa & Awa visiting the clinic

The Chief Nursing Officer, Mr Ismaila Njie, also gave us some good news - he will transfer 2 qualified Mid-Wives to work at the clinic, alongside the nurses, as and when it is "opened"

March 2009. Karafa and Awa are currently working in the hospital at Kuntair. This is the nearest medical centre for the villagers of Bakang, Karantaba and Tabana. It can take patients up to 4 hours to get to this hospital by donkey and cart or walk!! When our clinic is ready to "open" Karafa and Awa will be transferred to our clinic and will be on site for the villagers - what a relief!

Jan 2010 - Two more nurses sign up for training to S.E.N. status

We are very pleased to report that the two auxiliary nurses, MaSanneh Camara and Mama Sima, whom the principal of the Gambian Nursing College, Mr Mafugi Bojang selected on our behalf, are making good progress. They started their two-year course on 4th January 2010. Thanks to the generosity of two people, who have sponsored them, we have been able to pay the full cost of this training at the start of the course and so avoid any increase at a later date. Both students have signed a bond that states "I will work whole heartedly for the Bakang clinic, in the Jokadu District, for two consecutive years". This is in return for the sponsorship of their two-year training course.

In the meantime our two qualified nurses Karafa and Awa have settled in well at our clinic and are preparing for a busy time when the rainy season starts. The government have provided two auxiliary nurses and a qualified midwife to work alongside them. June through to the end of November will certainly test the clinic facilities, so we wait with interest to hear the verdict of the staff, the patients and the government.

Nov 2010

The Government, in their wisdom, decided to move our head nurse, Karafa Marong, to another hospital further up the country. We were a little dismayed at this move, as Karafa had barely completed twelve months working in our clinic. However, we are pleased to report that his replacement, a qualified midwife [male] has settled down well and appears to be doing a good job.

The two students, we have training, will complete their first year at the end of December. This first year has been mainly concerned with medical theory, which they have studied at the government nursing college at Basang. In January they will be very much involved with the practical side to nursing and will be working in the main hospital in Banjul for at least six months. We now await their first year exam results and report from the principal of the nursing college.

June 2011

Following the decision by the government to move our head nurse, Karafa Marong, to another clinic, we are pleased to see that he has been replaced by a qualified midwife, Pa Ceesay Pa, has taken on the responsibility of running the clinic and is doing a very good job. The clinic is going from strength to strength. It is now serving 8 villages, from within the surrounding area. People are also travelling all the way from Senegal to receive treatment, for they know that the clinic is open 24/7. Since, the "opening" in Nov 2009, 53 babies have been born in the clinic. The number of adults seen, in April, was just over 300 and the number of children, under the age of 5, was 143.

To go alongside this expansion we are pleased to report that we have been offered the chance of a computerised client information system, which would be run using a laptop computer. It was following an article that appeared here in the local magazine "Reflections" that Philip Moakes, of Beach Hut Software Ltd, contacted us offering his help and expertise. The necessary software is currently being developed and we hope that Philip will come with us on our next visit to The Gambia in November. If this can be arranged it would give Philip an excellent opportunity to see just what is required and how best he can provide the correct software to meet the needs of a poor African country that is so keen to move forward.

On the down side, the clinic is the desperate need for snake serum. Unfortunately there is a world shortage of this serum and so there is none in the vaccine fridge. It is just hoped that no one is bitten by say a black mamba snake, which is quite common in Jokadu district. In The Gambia there is also a shortage of antibacterials, but when we ask why? no two reasons for this shortage are the same!

On this visit we had a meeting with the principal of the Nurse Training College @ Bansang, Mr Mafugi Bojang. He introduced us to the two auxiliary Nurses Masanneh Camara and Mama Sima, whom he had selected to train to SEN status. This is the second pair of nurses that our charity has paid to train. They have now signed an agreement to work in our clinic for two years after they have qualified. They started their course in January 2010 and will finish in February 2012.
The second year of training is very practical and entails quite a lot of travelling between clinics and hospitals. We have agreed to help with their travelling expenses with a fixed sum of money paid to them at the start of each month.

Massaneh Camara & Mama Sima with signed documents.

March 2012

We are very pleased to report that the two auxiliary nurses, Massaneh Camara and Mama Sima, whom we had trained, in The Gambia, during the last two years to S E N status, passed all their exams and qualified at the end of February. They then had a month to rest/recoup and are now settling down to work at our Health Clinic at Bakang. If, for some reason, the government decided to move one or both of them then the government would have to provide replacement nurses. We have now trained four nurses during the past 5 years. The first female nurse we trained, Awa, is still at the clinic and now in charge of day to day running. She also has a little boy, who is now in the nursery class @ Bakang/Karantaba Lower Basic Primary School.

Massaneh and Mama - qualified Nurses to SEN status

Borehole - Water on Tap!

A borehole will be sunk to provide clean water. A submersible pump will be required plus a storage tank on a steel tower. During the visit in March, a contract was signed with a qualified engineer and work will commence in April.

One of the most important and fundamental requirements of the whole Kankudibi Health Clinic project is to have a ready and sufficient supply of clean drinkable water at all times. On the face of it, it looks as though that has been achieved although it is early days to be certain. An agreement, signed in March 2008, with Seedou Barrow of Regional Solar Energy, to provide this water has been honoured.

The project entailed drilling down about 30 metres into the ground until an aquifer was found that would provide an adequate supply of clean drinkable water. A 6 metre high steel tower was constructed and a 2000lt PVC tank placed on the platform provided at the top. A submersible pump was placed at the bottom of the borehole and the water then pumped up into the tank. A float switch was fixed in the tank and that controls the amount of water required to keep the tank full at all times. This whole operation is driven by solar energy as, in this part of The Gambia, there is no electricity or mechanisation. With 7 - 8 hours of sunshine most days, even in the rainy season, the use of solar power has to be the answer.

Since the clinic is not ready to use this water supply it has been diverted via a pipe from the storage tank to a stand-pipe that is sited near the clinic. The villagers can now draw their water by simply turning on the tap and filling their buckets and drums. It was decided to do this in order to test the supply and quality of the water, as there is a risk of contamination from saline or brackish water, which would be of no use in the clinic. The water can also be used during the block making and construction work for the staff accommodation and the utility building. So far so good, the reports from the villagers are positive.

The villagers have been told that once the clinic is ready to be opened, this water supply will be diverted for use in the clinic. The villagers will then have to return to using their original wells. Perhaps, at some later date, another borehole will be drilled for their benefit.

TOTAL COST OF BOREHOLE CONSTRUCTION £6,763

After 4 years of continued use it has become necessary to replace both the 2,000lt water collection tank and the Solar Pump that pumped the water from 30 metres down in the ground to the tank 6 metres above the ground. A crack appeared in the side of the tank and it is generally thought that the hot sun had brought this about. In the case of the pump it had never been serviced since its installation, being 30 metres below ground. However, now that the original pump has been both repaired and serviced it is to be kept as a spare, should any problem occur in the future.

The cost of the new tank + transport + installation was D12,500 [£277] and the new pump + installation and repair of the old pump was D20,700 [£460]

The original 7 stages have now been completed, easier to write about than to achieve!

Keep visiting this page to follow the progress of this exciting project.